The shoe-stink of privatisation

If you thought, you had seen the worst of privatisation, think again – Central Railways is going to privatise shoe-shining in 6 zones along the Central and Harbour Railway lines in Mumbai. Those who know the tremendous crowds on Mumbai’s local train stations are also familiar with the shoeshine worker sitting calmly in the surging wave of pushing humanity, waiting patiently for their next shoe to shine. The ‘tick tick tick’ sound of them hitting the shoe-brush against their wooden handy box makes their location known to those who are looking to have their shoes polished.

The regular Mumbaikar may not notice then, because they are as much a part of the local railway station, as the ubiquitous weighing machines in most railway stations. But even they will be surprised to know the shoeshine workers pay the railways Rs.75 every month through their co-operative societies. The railways makes about Rs.75,000 per months from these shoeshine workers considering that there are about 1,000 shoeshine workers on Mumbai’s railway stations.

Now, the livelihood of these 1,000 shoeshine workers are at risk, because in accordance with the national policy (what else!), railways has issues a tender inviting “open bidding” from interested private parties to run shoeshine stalls in six zones along the Central and Harbour Railway lines in Mumbai. The railways expects to make about Rs.15 lakhs per month from the privatisation. The shoneshine workers, some of whom have been in this profession for over 40 years, are willing to pay the reserve price quoted in the tender, through their cooperatives, but they are being outbid because of the open bidding system. The office bearers of these co-operatives, who are shoeshine workers themselves in various platforms of Mumbai’s railway stations claim that none of the private firms who have bid for the shoeshine stalls have anything to do with the shoeshine industry. The Central Railways will finalise the bids on October 28, 2007. Their representative, when contacted by the media, said that “it was an internal matter of the railways”.

India is yet again going to shine for some private moneybag, leaving 1000 more families in the dark.

Bloodshot eyes… year after year

We are now a small and a sick family. We have all fallen victim to Conjunctivitis (commonly called “pinkeye” or “Madras Eye” in India). It started off with my dad, and then spread to the entire family, including our little daughter. Newspapers in Mumbai are full of Conjunctivitis news. It is that time of the year, when Conjunctivitis is rampant in the city. When I called up my colleagues in Bangalore, two of them had also fallen ill and had not reported for work. So, if this is so common all over the country, and if people are not reporting for work, and there is say 2- 3 lost working days per person, imagine the gross loss of productivity. Forget the productivity; what is greater is the suffering and pain that one experiences. In an earlier posting,  I had written about the cost of treatment for diarrhoea in children. Now, treatment of Conjunctivitis is not cheap either. I think more than the medicine cost is the cost of consulting an eye specialist. So, in addition to the lost work days and pain and suffering, is the cost of treatment.

Conjunctivitis is highly contagious and quickly spreads from one to the other, so, just like in our family, the whole household usually gets infected very soon. We were very careful about not touching our eye and then touching each other, washing our hands often, not sharing towels and pillow cases, and so on; yet we all fell ill. So, one can only imagine in the slums where living spaces are so crammed and people have no other option but to share common resources, how easily it can spread.

The fact that Mumbaikars and people in other places around India suffer due to Conjunctivitis EVERY YEAR, around this time of the year (monsoon and post-monsoon) is almost like a foregone conclusion. Nobody even bats an eyelid (no pun intended) when hordes of people fall prey to this infection. In spite of having enough knowledge about the infection and knowing precisely when it strikes, we are unable to do anything to prevent it from happening year after year. So much for public health in our country! 

I had an interesting experience during the treatment of this infection. A drug which is commonly used in Mumbai (and other places also I presume) as first-line treatment for Conjunctivitis is a drug which contains corticosteroids, while the recommended treatment for bacterial Conjunctivitis (the most common, I think) is non-steroidal anti-inflammatory medications and antibiotic eye drops or ointments  I was told that schools here routinely stock the drug containing corticosteroids during monsoons, because of the high number of children who go to school with the infection. In fact, even I was advised by a friend to get this particular drug for Conjunctivitis. I did not not know about its contents. He said that anybody with Conjunctivitis vouches for the efficiency of this drug, and in fact this was most commonly prescribed drug by doctors everywhere. So, I went to the nearest chemist and asked for the drug. He laughed and said, that this drug was out-of-stock and I would have to procure it in black (paying almost double the cost) since there was huge demand for the drug. I walked away from the chemist in anger and went to another one. There, the same story was repeated. Finally, I decided to buy this drug, by paying that extra cost because my eye was hurting badly and I could not walk any further in the hot sun. Just after I had bought the drug, my wife called me to say that I should not use the drug as it contained corticosteroids and that it was usually used in the worst cases to reduce the discomfort from inflammation. On reading the label, I found that drug contained corticosteroids, and the warning said “indiscriminate and prolonged use of the drug could lead to glaucoma, cataract and fungal infections”. In fact, it can even cause permanent eye damage by inducing central serous retinopathy (CSR). Needles to say, the drug was a Schedule H drug (which was to be sold only on the prescription of a Registered Medical Practitioner), but I got it without even a single piece of paper. What is even more shocking is that, it is being used indiscriminately in schools and slums where people go and buy this from the Chemist across the counter at a price that the Chemist decides, because for most of the slum-dwellers, the Chemist also doubles up as their only “doctor”. 

I have uploaded some snaps of my Conjunctivitis-ridden eyes to show you the signs and symptoms. The first one shows the redness and watering from both the eyes, while the second one shows the swelling around the eyes, especially in the mornings. For more snaps, click here.

The mystique of medicine and the cost of treatment

How much does it cost to treat diarrhoea in children? A lot, as we realised when we came face-to-face with diarrhoea and the medical establishment, twice in the span of less than a month. I had written earlier about the water in our neighbourhood. Needless to say, our little one was down with her second bout of diarrhoea, in less than a month. We started out with homeopathy on both occasions. Our resolve to be patient and wait out until the infection dies out, was quickly overcome when we saw the condition of the child not improving.

The second time was worse than the first episode. A visit to the local doctor, not yielding any visible benefits, saw us rush for a consultation with a specialist pediatrician, who filled in two long sides of a prescription sheet with medicines and powders of different kinds. Banish any thought of rational medicines and good old home remedies! In fact, when we asked the doctor about some of the specifications of the medicines (more in the nature of clarification, rather than confrontation), he lost his cool and said “then why do you come to me?” – the arrogance of knowledge being mystified and given into a few hands!!! Anyway, we visited at least three different medical stores to get the array of powders and medicines – the hocus-pocus of modern medicines. The whole exercise in ignorance, set us back by about Rs.1000 (the second time). On closer examination, we realised that one of the costly powders was a substitute for its poor (but effective) and distant cousin – kanji (rice gruel), while another was a substitute for home-made ORS, and yet another was a replacement for milk (to not aggravate the loosies). As a parting shot, he also said that we need to get her stool tested, (but of course, the clinic also had a lab attached) and that in case she did not improve and pass urine in the next few hours, we had to get her admitted (and yes, he runs a children’s hospital also). No tips on how to take care of the child at home, or how to avoid hospitalisation – purely a “pill for every ill” or rather “a load of pills for every ill” approach.

 For more photos, click here.

Just opposite the housing colony where we live is a large slum. The children there, not only have access to the same (if not worse) water, but also have poor living conditions and all other typical features which characterise slums in cities. It was especially with reference to this slum, that the doctor has said “oh, diarrhoea, everybody gets it here”. If everybody gets it, and spends so much of their hard-earned money on the doctors and medicines, and syrups and tonics and lost wages, then why is nothing being done about it? One reason is definitely the mystique of modern medicine carefully preserved and crafted and refined by the practioners of the art, to keep common people from taking health in to their own hands. After all, if they do that, where will they make their living from? That’s the tragedy of commercialisation of medicine and medical education. Wither health for all???

We are like this only…

You wake up in the morning to the smell of brewing coffee. As you await your morning dose of newspaper, you decide to freshen up. You take those first few sleepy steps to the wash basin and suddenly you see RED and stop in fright….

But then you continue again, because you have to be brave, you have to wash your face, you have to brush your teeth, and you have to face those red worms that come along with the water, YOU HAVE NO OTHER ALTERNATIVE!!!

Dear friends, this is no scene from a horror movie, but a daily reality for those of us living around P.L.Lokhande Marg in Chembur. We are served with muddy water by the municipal corporation, filled with muck and different kinds of worms. They come in different shapes and sizes, but the wriggly squiggly squirmy red worms are the most common.

All our taps resemble wounded soldiers (well, they must all be deeply wounded – facing attack from the worms day in and day out). They are bandaged with different kind of filters – white cloth filters, plastic filters and fibre filters. But they fail miserably to stop the ingenious worms who make their way through the taps, into the water and straight into our unsuspecting mouths. A white cloth filter takes only a few minutes to become dark brown. I have taken a few pictures to share our story with you. I emptied out the worms from one of the tap filters into a basin and took some photos. (WARNING: Some of these images may cause dysentery, cholera and typhoid. Please view them only under medical supervision).

To see more photos click here.

An article in the Times of India, four years back (July 10, 2003) had reported about a study, which was conducted by the Society for a Clean Environment (Socleen) and funded by the Mumbai Metropolitan Regional Development Authority (MMRDA). The study which did random testing of piped water samples found that the level of fecal coliform (bacteria found in excreta)— one of the most important indicators of the safety of drinking water —was 1600 fecal coliform (fc) per 100 ml of water in P.L. Lokhande Marg, while the Bureau of Indian Standards’ safe norm is 10 fc per 100 ml.
The report also said that some of Chembur’s P.L. Lokhande Marg’s housing societies had the “worst water quality, with 70 per cent of the samples found to be unpotable”.

So friends, four years on, the situation has not changed. And as the famous by-line goes “we are like this only”. Probably, in another four years, I will post some more photos of the water here. Now I have to rush – I need to visit my neighbours and friends from the area who have been hospitalised with jaundice, dysentery, typhoid and various other afflictions, which the doctors here very comfortingly say” don’t worry, its very common in your area”. Untill next time, pray for us!!!

Initiation into Mumbai

Moving newly to a city is teaching us many things, starting with, ‘things are not cheap here’ (except the vada pav . Living opposite a slum invariably has its own lessons to teach. Firstly, the water to this area is visibly different from the rest of chembur/ govandi. It comes with worms (red, black.. all colours and shapes). The corporation blames the community and community blames the corporation. Net result… diarrohea is a perrenial problem. When we took Ashima to a doctor, she said, “oh diarrohea, no problem, everybody here has it”. We have two filters on every tap – one for the worms and second for the mud and silt. The boiling water residue here must contain all the minerals in the world. Milk and curd is sold in quantities as small as 100 ml. Not surprising because 1 litre packet milk price here ranges from 19 – 26 rupees a litre. A constant reminder of living here is that the underworld here is not so under the world. Many of the unorganised systems here are under somebody (respectfully called bhai)’s control. Yesterday, a shopkeeper and his son in Navi Mumbai was attacked and shop ransacked for not giving Rs.1001 to a ganesh pandal. An auto driver’s remark was quite telling of the situation here. We were coming back by an auto one night, and as we passed through a particular area, we saw crowds of people and people huddled together in small groups, the auto driver said “dus rupiya ka daaru peeta, aur sab log bhai banta hai” – they drink 10 rupees liquor and all of them turn into bhais(can’t find a suitable english term for this

If you see the stark contrast between the rich and the not-so-rich and the semi-rich and the almost-rich and then the different shades of poor, you won’t be surprised at the way life is organised here. The poshest bungalows and high-rises with state-of-the-art secuirity sit comfortably besides the poorest jhuggies. The latest cars jostle for space with the lady washing clothes on her doorstep (really!!! I saw a woman move her basin of clothes from outside her own door-step, to make way for an extra-wide latest car to move).